Objective To evaluate the mortality and morbility of children with severe traumatic brain injury (sTBI) following treatment with decompressive craniectomy and further analyze its long-term outcomes. Methods Seventeen children with sTBI undergone decompressive craniectomy between 2004 and 2010 were retrospectively studied.Quality of life of the patients who survived the operation was assessed by using the King' s outcome scale for childhood head injury (KOSCHI). Results Of 17 children with sTBI,the mean preoperative Glasgow Coma Scale (GCS) score was 5.27.Five children (29％) died postoperatively,of whom three children were died of cerebral infarction.Twelve children who survived the operation were followed up for average 4.6 years,which showed the mean KOSCHI score of 4.75.Among the 12 survivors,five patients (42％) experienced posttraumatic shunt-dependent hydrocephalus and four (33％) suffered ipsilateral and/or contralateral hygroma. Conclusions Although a high mortality rate is observed in the children with sTBI after decompressive craniectomy,the survived patients have satisfactory outcomes. Posttraumatic hydrocephalus and hygroma are two common complications after decompressive craniectomy for children with sTBI.